From the Guidelines
Ulipristal acetate (30 mg single dose) can be used as emergency contraception in lactating women, but breastfeeding should be interrupted for 24 hours after taking the medication. According to the U.S. Medical Eligibility Criteria for Contraceptive Use, 2010 1, breastfeeding is classified as a category 1 condition for emergency contraceptive pills, indicating that the benefits of using the method generally outweigh the risks. However, it is essential to consider the potential effects of ulipristal on breastfed infants. Some key points to consider when prescribing ulipristal for emergency contraception in lactating women include:
- Ulipristal is a selective progesterone receptor modulator that works primarily by delaying or inhibiting ovulation, and it can be effective up to 120 hours (5 days) after unprotected intercourse.
- The temporary suspension of breastfeeding is advised because ulipristal is excreted in breast milk, and the effects on breastfed infants have not been well studied 1.
- After the 24-hour period, breastfeeding can safely resume.
- The woman should also be counseled about ongoing contraceptive options, as emergency contraception does not provide continued protection against pregnancy. It's worth noting that the CDC supports the use of ulipristal (Ella) as an emergency contraceptive, highlighting its potential benefits, particularly for women who are overweight or obese 1. However, the primary concern in lactating women is minimizing infant exposure to the drug while maintaining milk production.
From the Research
Ulipristal for Emergency Contraception in Lactating Women
- There is no direct information in the provided studies regarding the use of ulipristal for emergency contraception in lactating women 2, 3, 4, 5, 6.
- However, one study mentions that providers should be prepared to counsel women, including breast-feeding women, about emergency contraception options 5.
- The studies primarily focus on the efficacy, safety, and comparison of ulipristal acetate with other emergency contraceptives, such as levonorgestrel, in the general population 2, 3, 4, 6.
- Ulipristal acetate is shown to be effective in preventing pregnancies when taken within 120 hours of unprotected intercourse, with some studies suggesting it may be more effective than levonorgestrel, especially when taken later than 72 hours postcoitus 2, 3, 5, 6.
- The mechanism of action of ulipristal acetate involves delaying or inhibiting ovulation, and it is generally well-tolerated with minimal adverse effects 2, 3, 4, 6.